Today is the fifth birthday for the Affordable Care Act, or Obamacare. As the intense political and legal battles continue over the health care program, here’s a look at the constitutional issues that have cropped up in the Supreme Court in recent years.
The Patient Protection and Affordable Care Act passed Congress in May 2010, after Democrats gained control of the House and Senate after President Barack Obama’s election in 2008.
The Democrats had enough votes in the Senate to overcome a cloture vote and filibuster, and enough Yes votes in the House to pass the ACA, despite 34 Democrats who voted against it. The Republicans were unanimous in their opposition to Obamacare. President Obama signed the bill into law on March 23, 2010. Almost immediately, opponents mounted constitutional challenges to the ACA.
Conservative opposition to Obamacare also fueled voting results in the 2010 mid-term elections. The Republicans took back control of the House and the Tea Party movement gained popularity in the ACA’s backlash.
The first serious constitutional challenge to Obamacare came in June 2012, when the Supreme Court ruled on the legality of parts of the very complicated law.
Using an approach endorsed by Georgetown Law professor Randy Barnett, the ACA was challenged on the constitutionality of the individual mandate, the part of Obamacare that requires many people to carry health insurance, or face a financial penalty.
Barnett argued that such a provision posed an “unprecedented” conflict with the Constitution’s Commerce Clause. Five Supreme Court Justices agreed with Barnett.
“The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause,” Chief Justice John Roberts said in his opinion in NFIB v. Sebelius. “That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.”
However, Chief Justice Roberts said that Congress had the legal power to collect the individual mandate financial penalty as a tax, payable on annual income tax forms. So the Supreme Court upheld most of the ACA as constitutional.
The ruling shocked the ACA’s opponents and confused several major news outlets, which initially reported the wrong outcome from the decision.
And almost immediately, new legal challenges began as the Supreme Court’s Obamacare decision became an issue in the 2012 presidential contest between Obama and GOP challenger Mitt Romney.
After Obama’s re-election in November 2012, two related challenges to parts of Obamacare were decided in the Supreme Court last year: the Hobby Lobby-Conestoga Wood cases.
But before those case decisions were announced in June 2014, a series of delays and implementation policy decisions made by the Obama administration as the March 31, 2014 enrollment deadline approached angered an already agitated opposition.
A divided Supreme Court in the Hobby Lobby ruling said the two for-profit companies that requested religious exemptions from the Affordable Care Act, or Obamacare, could have them under limited circumstances.
In the 5-4 decision, Justice Samuel Alito said the closely held corporations cannot be required to provide contraception coverage under Obamacare if they had religious objections. The decision was narrowly focused on just the contraception mandate, and it doesn’t invalidate other parts of Obamacare.
The third major challenge to Obamacare at the Supreme Court is in progress, after arguments were heard on March 4 in the King v. Burwell case.
King v. Burwell has received much public attention because it is a significant challenge to the Affordable Care Act, or Obamacare. The Justices heard arguments on March 4, 2015 and will try to decide if language in the act precludes people from getting tax breaks on premiums sold by federally run health-care exchanges in 36 states.
The Court decision is due in late June, and a decision to curb the subsidies could have a big impact on Obamacare’s future.
